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Organization
LIC MARRIAGE AND FAMILY THERAPY PLLC
Active
Organization
LIC MARRIAGE AND FAMILY THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER DISOMMA LICENSED (MARRIAGE AND FAMILY THERAPIST)
(631) 365-9350
Entity
Organization
Contact information
Practice address
3164 21ST ST # 121, LONG ISLAND CITY, NY 11106-4573
(631) 365-9350
Mailing address
3164 21ST ST # 121, LONG ISLAND CITY, NY 11106-4573
(631) 365-9350
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
—
NULL
106H00000X
Marriage & Family Therapist
Primary
—
—
Other
Enumeration date
06/02/2021
Last updated
07/27/2023
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